November 11, 2010
How to tell if you're bound for burnout
Stress and burnout are the most common problems for those who care for someone with Alzheimer's disease. And, in turn, caregiver stress — the emotional strain of tending to a loved one — is one of the biggest reasons people with the disease enter nursing facilities.
Take stock of your stress level by asking yourself whether you're experiencing any of the following emotional and physical symptoms. For an even better reality check, have your partner or other loved one answer the questions for you to see what someone close to you thinks.
There's no formula for defining your stress level, but if your yes answers outnumber your no answers, or if just two or three of the categories seem to apply to you, consider taking steps to ease your situation.
1. A short fuse
- Do you lose your temper easily?
- Do you feel angry with your parent?
- Do you feel irritable toward other family members or find yourself snapping at them?
One of the more obvious signs of caregiver stress is losing your cool easily. Frustration may particularly increase when obstacles or challenges come up, whether major or minor.
2. Emotional outbursts
- Do you cry often or unexpectedly?
- Do you experience feelings of despair?
- Do you have dramatic mood swings?
It's natural to grieve as your parent's condition declines. It's also normal to feel a complicated range of emotions about having to parent your parent. But if you're increasingly emotional or feeling emotionally fragile, there may be something more going on.
Depression is a real risk for caregivers. Even if you're not clinically depressed, emotional outbursts can be an unconscious outlet for feelings of being overwhelmed.
3. Sleep problems
- Do you have trouble falling asleep?
- Do you have trouble staying asleep?
- Do you wake up tired?
Caregiving -- especially full-time -- requires tremendous physical effort, even in the disease's early stages. But if your parent is sundowning, wanders, or has disrupted sleep, you lose opportunities to rest on top of the tiring work you do all day. Trouble getting to sleep or staying asleep can also be caused by stress, anxiety, and depression.
4. Significant weight change
- Have you recently gained weight?
- Have you recently lost weight?
For some people, stress can result in weight loss when they can't seem to find time to eat adequately or nutritiously. Anxiety often lowers the appetite as well. For others, feeling stressed or guilty leads to weight gain from mindless or emotionally triggered eating, frequent snacking, or quick but unhealthy food choices. Changes in eating and sleeping habits can also indicate depression.
If your weight has changed by more than five or ten pounds since you began caring for your parent, your body may be sending you a signal that you need help.
- Is it difficult to get motivated to accomplish things?
- Do you feel sluggish even after a good night's rest?
- Is it hard to concentrate when you read or perform other mental tasks?
- Do you feel bored?
Caring for someone with Alzheimer's involves constant vigilance and activity. So if you feel "off" instead of "on," it's hard to perform your duties adequately. It may be that you find parts of the caregiving puzzle more challenging than others -- for example, managing your parent's finances or other health concerns.
Sometimes the routines that people with Alzheimer's thrive on can become stifling to a healthy adult child. Routines do help you and your parent get through the day more easily, but they can leave you feeling like you're stuck in a monotonous rut.
6. Physical ailments
- Do you get headaches often?
- Have you had colds one after another?
- Does your back or neck ache, or do you have other chronic pain
- Have you developed high blood pressure?
Mental and emotional stress can cause physical disorders. For example, stress can lead to headaches that are more frequent, more persistent, or stronger than you're used to. Under stress, your body is in a constant state of alert, which can cause your body to produce excessive amounts of the hormone cortisol, which can have many effects. You'll also lack the time or inclination to properly take care of yourself, setting the stage for more stress. Caregivers under stress may also find themselves suffering from high blood pressure or more frequent stomachaches, cold symptoms, muscle aches, or other health problems.
7. Social isolation
- Do you sometimes go a whole day without seeing another adult aside from your parent?
- Have you dropped out of your usual activities to care for your parent?
- Can you remember the last time you had a whole day to yourself?
- Do you feel like nobody understands?
- Do you sometimes feel that other family members don't care as much about your parent's fate as you do?
Getting out can simply be hard if you're responsible for providing care. You may feel you lack the time for your former pursuits. Your parent's changes in behavior may also make you feel embarrassed or make going out in public too onerous to attempt. Whether intentionally or not, you may become withdrawn. Unfortunately, social isolation itself contributes to stress, whereas being with others and taking time for yourself are both replenishing.
8. Complaints from family
- Have you been accused of being a "control freak"?
- Have you been told you don't spend enough time with your partner or children?
- Are arguments with siblings over your parent's care on the rise?
It's a common caregiver temptation -- and mistake -- to take on the entire burden of care. It's also easy to make ourselves think that we have everything under control or that things aren't so bad. Denial is a powerful emotion. When you're in the thick of things, it can be hard to see other ways of doing it. Listening to an outsider can be healthy, even if you don't agree. What may sound like a criticism or complaint may have a nugget of truth that relates to your emotional well-being.
Alzheimer's care can become all-consuming. It's a bit like the frog who stays in the pot of water as the heat is turned up bit by bit; it doesn't realize it's in hot water until it's too late. Every Alzheimer's caregiver eventually needs assistance -- usually sooner rather than later, and usually from a variety of sources.
If you need a hand, know that plenty of forms of help are available. You can make changes in your care routine, enlist the part-time efforts of friends and family, tap into community resources, and hire assistance as well. No Alzheimer's caregiver can go it alone well. And they shouldn't try -- for their sake and their parent's.
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